Middle East journal of anaesthesiology
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Middle East J Anaesthesiol · Jun 2005
Case ReportsAnesthetic implications for video assisted thoracoscopic thymectomy in myasthenia gravis.
Thymectomy is an established therapy in the management of generalized myasthenia gravis (MG). However, the optimal surgical approach to thymectomy has remained controversial. There are advocates for transternal, transcervical approaches for "maximal" thymectomy. ⋯ We believe that the use of NMRT provides good operative and postoperative conditions. In this report we have described two different NMRTs, one with TEA and the other without. Further studies are needed on large number of cases to establish an anesthetic protocol for VATT.
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Middle East J Anaesthesiol · Jun 2005
Case ReportsA novel technique for off pump bidirectional Glenn shunt--safety issues--a case report.
A new technique to decompress the superior vena cava (SVC) during off pump bi-directional Glenn [BDG] shunts is described. Cerebral protection maneuvers and the safety concerns of the technique are addressed.
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Middle East J Anaesthesiol · Jun 2005
Clinical TrialSpontaneous intraoperative hypothermia and cerebral protection in aneurysmal subarachnoid hemorrhage.
In patients with aneurysmal subarachnoid hemorrhage (SAH), a trend towards cerebral protection has been demonstrated with intraoperative mild hypothermia. Mild to moderate spontaneous hypothermia occurs intraoperatively if no active measures are taken to warm the patient. The present study investigated the cerebral protective role of such spontaneous intraoperative hypothermia in patients with aneurysmal SAH. ⋯ The findings of the current study suggest that mild spontaneous intraoperative hypothermia offers cerebral protection in patients undergoing surgery for aneurysmal subarachnoid hemorrhage. This protective role of seems to be related to the anatomical location of the aneurysm.
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Middle East J Anaesthesiol · Jun 2005
Comparative StudyPressure measurements during cardiac surgery--internal jugular vs central venous.
Although central venous pressure (CVP) is a valuable guide and measurement during cardiac surgery anesthesia, there are many occasions however, when the time consumed in inserting a peripheral catheter, defeats the actual purpose. The purpose of this study was to compare central venous pressure and internal jugular veins pressure, and to see whether the jugular veins pressures were a reliable guide to central venous pressure monitoring. Simultaneous measurements of the internal jugular (both left and right side) and right atrial venous pressures were made in 70 patients undergoing cardiac surgery both at times when the chests were closed and when they were opened. ⋯ Then the CVP and internal jugular veins were measured six times during anesthesia and postoperatively. A good correlation was found between pressures of right and left internal jugular veins with that of CVP both at times when the chests were closed and when they were opened. It is concluded that left and right internal jugular vein pressures are reliable guides to central venous pressures during anesthesia in cardiac surgery.